Understanding Open Enrollment and Special Enrollment
Open Enrollment Period
This is the yearly period from November 1 to January 15 during which you can buy health insurance through the Marketplace or make changes to your existing health plan. If you don’t enroll during this time, you can’t purchase a health plan until the next Open Enrollment Period — unless you qualify for a Special Enrollment Period.
Special Enrollment Period
A Special Enrollment Period takes place outside the yearly Open Enrollment Period. You can enroll in a health plan through the Marketplace during a Special Enrollment Period only if you experience a Qualifying Life Event.
To be eligible for Virginia's Insurance Marketplace coverage, individuals / households must:
- Reside in Virginia.
- Be U.S. citizens, U.S. nationals, or lawfully present immigrants for the entire time they plan to have coverage.
- Not be incarcerated (unless pending disposition of charges).
- Be uninsured, generally not eligible for Medicaid or Medicare, and not have an offer of affordable employer-based coverage.
Lowest monthly premium
Highest costs when you use healthcare services.
Bronze plan deductibles — the amount of healthcare costs you pay yourself before your insurance plan starts to pay — can be thousands of dollars a year.
Good choice if: You want a low-cost way to protect yourself from worst-case medical scenarios, like a serious illness or injury. Your monthly premium will be low, but you’ll have to pay for most routine care yourself.
Moderate monthly premium
Moderate costs when you use healthcare services.
Silver deductibles — the costs you pay yourself before your plan pays anything — are usually lower than those of Bronze plans.
IMPORTANT: If you qualify for cost-sharing reductions you must pick a Silver plan to access these savings. You can save hundreds or even thousands of dollars per year depending on how much care you use.
Good choice if: You qualify for cost-sharing reductions— or, if not, you’re willing to pay a slightly higher monthly premium than Bronze to have more of your routine care covered.
Higher monthly premium
Lower costs when you use healthcare services
Gold plan deductibles are usually low.
Good choice if: You’re willing to pay more each month to have more costs covered when you use healthcare services. If you use a lot of care, a Gold plan could be a good value.
Highest monthly premium
Lowest costs when you use healthcare services.
Deductibles are very low, meaning your plan starts paying its share for covered services earlier than other plan categories.
Good choice if: You usually use a lot of care and are willing to pay a higher monthly premium, knowing nearly all other costs will be covered.
How to Enroll
This video shows how easy it is for individuals and families to enroll in a new health plan. Virginians who are uninsured, are self-employed, or have jobs that don’t provide affordable insurance options can use the Marketplace to enroll in a health plan. Individual and family plans are available to those who don’t have access to affordable health coverage. Marketplace consumers may also qualify for financial assistance.
Enrolling in a Health Plan is Simple
Virginia’s Insurance Marketplace lets you shop for, compare, and purchase affordable, high-quality health insurance plans with comprehensive coverage. Plus, 9 out of 10 customers qualify for financial savings.
Steps To Enroll
Most health plans must cover minimum essential benefits required by law and include preventive services — like vaccines and screening tests — at no cost to you. All Marketplace plans cover mental health and substance abuse services as essential health benefits and must cover treatment for preexisting medical conditions. You can pick a health plan with or without dental benefits. If you pick a health plan without dental benefits, you can still get a separate dental plan. Get started by clicking "Get Covered" and enroll with the steps below.
1. Shop, compare plans, and get a quote.
Select "Browse for health & dental plans". The Marketplace makes it easy for you to choose the type of coverage you need. You can filter your results, compare costs, and select the plan that works for you.
2. Gather your information.
To apply for your selected plan, make sure you have the following materials for each adult who will be covered:
- Photo ID.
- Social Security number.
- Most recent tax return.
- Pay stubs from the last four weeks.
- Immigration documents, if applicable.
3. Select your plan and enroll.
4. Pay your first month's premium.
To begin your coverage, you must make your first monthly payment (called the “premium”). Making payments is easy — plus, the Marketplace has options for applying for financial assistance.
You're covered!
Begin using your health insurance and get the care you need.
A Marketplace By Virginia, for Virginians
Gloria, of Hampton, recently retired and needed affordable health coverage that allowed her to keep the same doctors. With the help of a Virginia certified agent, Gloria was able to find a plan that fit her needs and budget.
Look at what our consumers had to say about their Virginia's Insurance Marketplace health plans!
When I turned 26, I was off my parents' plan, so I knew that I needed to look for my own insurance. I was able to find a very affordable plan and all that I'm paying is $10 a month.
Victoria, Springfield
It was so easy to compare which options I had. Saving money on prescriptions, doctor's visits, just having an affordable plan in general opens up my finances to be able to do those things that I really want to do.
Bailey, Richmond
I have a lot of health issues. When I was told about the Marketplace, I found out to my surprise that I could afford it. With my medications, most of them, I do not pay anything out of pocket.
Janetta, Roanoke
Virginia Medicaid/FAMIS
The Marketplace will also check eligibility for low-cost or no-cost health coverage programs through Virginia Medicaid or Family Access to Medical Insurance Security (FAMIS is Virginia’s health insurance program for children). For additional information about Medicaid coverage in Virginia, you can visit Cover Virginia or call 1-833-522-5582.
Helpful Resources:
- Consider these questions when choosing a plan.
- Download the Marketplace enrollment checklist.
- Visit the Marketplace Help Center to get contact information for assistance over the phone or in person.
- Follow the links to see plans offering health and dental coverage for 2024.
- Free Translation Services are available. Call the Consumer Assistance Center at 1-888-687-1501 for assistance.
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Assisters in your community can help with every step of the application and enrollment process. They provide free, unbiased enrollment assistance, with options to meet virtually or in person.
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